Vol 5, No 4 (1998)


Introduction in the Russian Federation of the International Statistical Classification of Diseases and Related Health Problems, 10th revision

Zhuravlev S.M.


The published article is the last one that Professor S.M. Zhuravlev worked on. This version was not final; the author planned to refine it and clarify some wording. However, fate had other plans.

N.N. Priorov Journal of Traumatology and Orthopedics. 1998;5(4):3-7
pages 3-7 views

Development and new turn of microsurgery in native traumatology and orthopaedics

Azolov V.V., Petrov S.V., Alexandrov N.M., Petrov S.A., Mitrofanov N.V., Nosov O.B.


The brief history of the development of microsurgery in native traumatology and orthopaedics is presented. Complex use of the methods of classic and precision technique are described, new methods for the substitution of the nerve trunk and bone defects are suggested.

N.N. Priorov Journal of Traumatology and Orthopedics. 1998;5(4):8-11
pages 8-11 views

Experimental study of the possible use of different microsurgical operations for spinal cord revascularization (2nd report)

Stepanov G.A., Shaposhnikov Y.G., Grishin I.G., Mitskevich V.A., Kamenev Y.F., Kolesnikov S.A.


Eleven experimental microsurgical operations were performed in cadavers. The operations were carried out to correct various types of vascular disorders observed in spinal injury (disturbance of arterial inflow, impediment of venous outflow, combination of arterial and venous circulation disturbance). The necessity of the differential approach to the circulatory disturbance correction using techniques specially elaborated for every type of vascular disorders is demonstrated. New surgical methods and indications to their use are presented.

N.N. Priorov Journal of Traumatology and Orthopedics. 1998;5(4):12-16
pages 12-16 views

Combined method for the restoration of radial and ulnar margin of the hand

Alexandrov N.M., Petrov S.V.


New approach to fingers reconstruction which provides the achievement of adequate functional outcome and minimum loss for donor sites is elaborated. The indications to this method are given. It is detected that the use of the blood-supplied segments of tubular bones enables to form the bone base of finger resistant to the resorption. It is also shown that in the forming of first interfinger interval is reasonable to use dermal-fatty flaps on temporary nutrition pedicles. The method of double flap formation for the prevention of necrosis is suggested.

N.N. Priorov Journal of Traumatology and Orthopedics. 1998;5(4):16-20
pages 16-20 views

Diagnosis of acute carpal instability in radial fractures

Golubev I.O., Shershneva O.G.


The analysis of X-rays of 873 patients with radial fractures was performed. The signs of carpal instability were found in 104 cases. Detailed examination of 32 patients detected clinical symptoms of instability in 17 cases. The most reliable X-ray signs of intercarpal ligament rupture were the following: changes of lunatoscaphoid angle before and after reduction, widening of the lunatotriquentral gap and degree of lunatocapitate angle before the reduction.

N.N. Priorov Journal of Traumatology and Orthopedics. 1998;5(4):20-23
pages 20-23 views

Tendinous-muscular transposition for the treatment of nn median us, ulnaris, radialis injury sequelae

Grishin I.G., Shiryaeva G.N., Polotnyanko V.N.


The treatment results of injury sequelae of n. medi- anus and/or n. ulnaris (184 patients) and n.radialis (33 patients) are summarized. The indications to tendinous- muscular transposition, time for surgery are presented; the most effective method for the restoration of thumb apposition, correction of claw-like hand deformity and restoration of active extension of the hand and fingers are distinguished. High efficacy of tendinous-muscular transposition and its significance for the treatment of nn medianus, ulnaris, radialis injury sequelae is shown. Follow up ranged from 2 months to 16 years, good and satisfactory results were in 96% of patients.

N.N. Priorov Journal of Traumatology and Orthopedics. 1998;5(4):23-26
pages 23-26 views

Possibilities to optimize total replacement of fingers in patients with severe posttraumatic hand deformities

Korotkova N.L.


On the experience of total replacement of fingers in 49 patients with posttraumatic hand deformities the main strategies for the improvement of outcome are detected: 1) successive restoration of damaged structures, including skin restoration, re-establishment of normal anatomical correlation of bone structures and total joint replacement; 2) perfection of the implant design; 3) application of precious technique. Use of such approach enabled to restore the motion volume in injured joints within the limits of 30-40 degrees as well as to widen the quota of patients for reconstructive surgical treatment at the account of patients with more severe pathology.

N.N. Priorov Journal of Traumatology and Orthopedics. 1998;5(4):26-29
pages 26-29 views

Substitution of bone defects and pseudoarthroses of upper limbs with vascularized autografts

Evgrafov А.V., Mikhailov A.Y.


From 1979 to 1998 at the Department of Microsurgery and Hand Injury (CITO) 68 patients, aged 6-52, with pseudoarthroses of the humerus (31 patients), forearm (34 patients) and capral bones (3 patients) were operated on. Forty-six patients had bone defects following injury and its complications. In 18 patients bone defects were due to bone tumors and in 4 - congenital deformity. Plasty with vascularized osseous (54 cases), dermal-osseous (11 cases) and muscular-osseous (3 cases) autografts was performed to substitute the bone defects. Good and satisfactory results were achieved in 63 out of 68 cases. In 4 patients unsatisfactory outcomes resulted from thrombosis of microvascular anastomoses. Conclusion is given that compared to routine treatment method the substitution of bone defects of upper limbs with vascularized autograft at least 2-3 times reduces the rehabilitation terms.

N.N. Priorov Journal of Traumatology and Orthopedics. 1998;5(4):29-32
pages 29-32 views

Myoplasty by flaps with axial blood-supply in infectious complications after hip replacement

Pshenisnov K.P., Danilyak V.V., Klyuchevskiy V.V.


After 359 total hip replacements (305 patients) infectious complications developed in 12 (3.3%) cases. Three cases were analyzed. To arrest the chronic inflammation, filling of residual cavities and substitute dermal defects muscular and myodermal flaps from m.tensor fasciae latae, m.rectus femoris and m. vastus lateralis with axial blood supply were used. Stopping of inflammatory process and radical closing of wound defect was achieved in all cases. In 2 patients it was possible to preserve stable to dislocation hip implants by means of wrapping up the implant neck with muscular flap.

N.N. Priorov Journal of Traumatology and Orthopedics. 1998;5(4):32-36
pages 32-36 views

Correction of vascular, thrombocytic and coagulative system of homeostasis in trauma and orthopaedic microsurgery

Mironov N.P., Svetlov V.A., Vabishchevich A.V., Krupatkin A.I., Fedotov S.A.


To improve the blood circulation during reconstructive operations with microsurgical technique acelysin (1.92±0.19 mg/kg) and clexane (0.59±0.07 mg/kg) was applied intra- and postoperatively in 16 and 11 patients, respectively. Control group included 12 patients. The study of coagulative, vascular and thrombocytic systems showed that the drugs were effective to keep up moderate blood hypocoagulation during and after long microsurgical operations. Acelysin provided prolonged hypocoagulation state while clexane had less prolonged and more slight effect.

N.N. Priorov Journal of Traumatology and Orthopedics. 1998;5(4):36-40
pages 36-40 views

Indications and contraindications to application of different distraction methods of the ankle in endoscopy

Mironov S.P., Cherkes-Zade D.D., Orletskiy A.K., Cherkes-Zade T.D.


In 20 patients with sequelae of the ankle injuries arthroscopic operations were performed. Different methods of distraction were used depending upon patient’s age, joint size, pattern and localization of intra-articular pathology, type and planned duration of surgery. In 18 patients follow up ranged from 1 to 5 years. In 16 patients, significant improvement was achieved, 2 patients had pain in joint under prolonged load. Different types of the ankle distraction were described. On the base of publications and authors’ experience the advantages and disadvantages, indications and contraindications of those distraction types were presented.

N.N. Priorov Journal of Traumatology and Orthopedics. 1998;5(4):40-44
pages 40-44 views

Stable functional osteosynthesis with trans- osseous fixation in dislocations and fracture- dislocations of acromial end of clavicula

Urazgildeev R.Z.


The evaluation of 141 patients with dislocations and fracture-dislocations of acromial clavicula end was performed. All patients were divided into 3 groups depending upon the treatment method. Two groups were the control ones: 1st - 52 patients (36.9%) were treated conservatively; 2nd - 44 patients (31.2%) were operated on; 3rd - 45 patients (31.9%) were subjected transosseous osteosynthesis using the author’s device. The description of the device and osteosynthesis technique was given. The device allowed to perform the complete reposition, elimination of all types of displacement and provided the stable fixation at any position of the patient’s body. It was possible to perform additional correction when necessary. The long-term results assessed using specially elaborated score system showed that conservative treatment gave good and satisfactory outcomes in 66.7% of cases, in operative treatment such results were achieved in 79.5% of cases and in 97.7% of cases when the suggested technique was used.

N.N. Priorov Journal of Traumatology and Orthopedics. 1998;5(4):44-48
pages 44-48 views

Effect of simultaneous dosaged distraction on the preservation of injured growth zone

Merkulov V.N., Shalnev A.N., Lekishvili M.V., Dorokhin A.I., Sukhanov A.A.


Experimental study was performed on 22 puppies aged 3-8 months. Growth zone of the distal femur was examined after the modeling of its injury. There were three experimental groups: 1st - formation of 1-2 mm diastasis between the fragments using simultaneous distraction and fixation with interosseous osteosynthesis device on the day of injury (12 dogs); 2nd - formation of 1-2 mm diastasis and fixation with the device 2-3 days after injury (5 dogs); 3rd - treatment of the injured growth zone with plaster cast (5 dogs). Radiologic and morphologic examinations of the growth zone were performed. The best results were obtained in the 1st experimental group.

N.N. Priorov Journal of Traumatology and Orthopedics. 1998;5(4):48-51
pages 48-51 views

From Practical Experience

Our modification of the splint for the treatment of injuries of the finger extensor tendon at the level of the distal interphalangeal joint

Zolotov A.S.


A large number of methods have been proposed to treat injuries of the hand extensor tendon at the level of the distal interphalangeal joint, the so-called "hammertoe". These include the use of various plaster casts, metal and plastic splints, tendon suture, transarticular fixation with Kirschner spokes, etc. Meanwhile, getting a good result in the treatment of this minor injury is not easy. After many years of trying different ways to treat the hammer toe, we chose the method of fixation of the distal interphalangeal joint with a palmless, unlabelled concave aluminum splint.

N.N. Priorov Journal of Traumatology and Orthopedics. 1998;5(4):52-53
pages 52-53 views


Specialized surgical treatment of gunshot wounds of the hand: status, problems, and prospects

Nikolenko V.K.


Surgery of gunshot wounds of the hand is one of the branches of military-field surgery with its inherent strategic, tactical and methodological peculiarities. It is generally accepted that all wounds to the hand should be singled out as a special category of patients subjected to compulsory delivery to the stage of specialized care. This is determined by two circumstances: predominantly severe pathology in gunshot wounds of hand, the most complex organ in anatomical and functional respect, and possibility of providing complete assistance only by an experienced, properly trained surgeon, who knows the operative methods of restoration of damaged structures.

N.N. Priorov Journal of Traumatology and Orthopedics. 1998;5(4):54-59
pages 54-59 views


Lesions and diseases of the distal radioulnar joint. Part II. Treatment

Golubev I.O.


The treatment of fresh lesions of the distal radioulnar joint (DLLJ) has undergone significant changes in the last decade. While conservative methods used to be preferred, with the advent of new technologies such as computed and magnetic resonance imaging and arthroscopy, the treatment approach has become more radical. Fractures of the radius penetrating the DLLS, i.e., fractures of the sigmoid notch, require the same treatment as fractures of the carpal articular surface, where a 2 mm displacement is considered unacceptable because it leads to the development of deforming arthrosis within 5 years in 100% of cases. Complete removal of the displacement avoids osteoarthritis in 85% of cases.

N.N. Priorov Journal of Traumatology and Orthopedics. 1998;5(4):60-63
pages 60-63 views

Reviews, literature review

N.E. Mahson, A.L. Mahson. Adequate surgery for shoulder and pelvic girdle tumors (M., 1998)

Burdygin V.N.


The book is devoted to one of the most difficult sections of orthopedic oncology - the treatment of patients with tumors of the clavicle, scapula, proximal humerus and pelvic bones.

N.N. Priorov Journal of Traumatology and Orthopedics. 1998;5(4):64-65
pages 64-65 views

S.P. Mironov, M.B. Tsykunov. Fundamentals of rehabilitation of athletes and ballet dancers with injuries and diseases of the musculoskeletal system (M., 1998)

Polyaev B.A.


The publication of the book under review should be considered very timely: until now only translated editions were published on this problem, as a rule, intended for coaches and physicians of sports teams. At the same time, the pathology of musculoskeletal system of sportsmen and ballet dancers is studied by orthopedists-traumatologists, who, even if they are familiar with the specifics of surgical treatment of this contingent of patients, most of them have no clear idea of how rehabilitation process should proceed, what rehabilitation actions can be, what are general indications and contraindications for application of any means of rehabilitation.

N.N. Priorov Journal of Traumatology and Orthopedics. 1998;5(4):65-65
pages 65-65 views

All-Russian Scientific and Practical Conference "Hereditary Skeletal Diseases"

Mikhailova L.K.


The conference, which was held at CITO on October 7-8, 1998, was attended by 170 specialists from different regions of Russia and the CIS. The program of the conference included four main topics: 1) hereditary systemic skeletal diseases (HSSD) - an urgent scientific, medical, and social problem; 2) genetics of HSSD; 3) diagnosis of HSSD; and 4) treatment of HSSD.

N.N. Priorov Journal of Traumatology and Orthopedics. 1998;5(4):66-66
pages 66-66 views


In memory of Yevgeny Antonovich Wagner


On September 22, 1998 would have been 80 years since his birth and 58 years of medical, scientific, pedagogical and social activities of Prof. Evgeny Antonovich Wagner, Academician of RAMS, Honorary Rector of the Perm State Medical Academy.

N.N. Priorov Journal of Traumatology and Orthopedics. 1998;5(4):67-67
pages 67-67 views


Elena Gavrilovna Lokshina


Professor E.G. Lokshina, Honored Scientist, turned 80 years old. Elena Gavrilovna meets her glorious anniversary full of energy, surrounded by her students, with a huge luggage of scientific achievements and successes in therapeutic activity. The school of orthopedic traumatologists, founded by her, is known throughout our country; her students work in many countries of the world.

N.N. Priorov Journal of Traumatology and Orthopedics. 1998;5(4):

Nahim Evseevich Machson


A famous surgeon, traumatologist and orthopedist, doctor of medical sciences N.E. Makhson is 80 years old.

N.N. Priorov Journal of Traumatology and Orthopedics. 1998;5(4):

Vladimir Ivanovich Shevtsov


Vladimir Ivanovich Shevtsov is one of the first and talented pupils of academician G.A. Ilizarov, General Director of the Russian Scientific Center "Restorative Traumatology and Orthopedics", Doctor of Medicine, Professor, Honored Scientist of the Russian Federation.

N.N. Priorov Journal of Traumatology and Orthopedics. 1998;5(4):

Gennady Petrovich Kotelnikov


January 11, 1999 will mark the 50th anniversary of his birthday and 25 years of scientific activity of the Rector of Samara State Medical University, Professor G.P. Kotelnikov.

N.N. Priorov Journal of Traumatology and Orthopedics. 1998;5(4):

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